Examining Influences of Place-Based Long-Term and Contemporary Neighborhood Factors on Aging-Related Disease Risk Trajectories: Leveraging the HANDLS Dataset - Populations residing in more limited age-friendly neighborhoods (AFN) are at elevated risk for earlier and more pronounced cognitive and functional decline and increased frailty. Indeed, the neighborhood environment is posited as a core driver of accelerated aging and multilevel biopsychosocial factors through its impact on its residents. AFN can be characterized by domains including transportation, civic participation, communication and information, communal participation, health services and resources, housing, ease of walkability, and building and outdoor spaces. In this way, AFN represent vital but understudied opportunities to create and sustain rich resources that support residents and their ability to age in place across the lifespan. We posit that understanding residents and their neighborhoods past and present will allow us to maximize healthy aging via characterization of pathways to three of the most prevalent risks to healthy aging—cognitive and functional declines and increased frailty. In sum, we aim to a) understand the longitudinal relations of long-term and contemporary (L&C) aspects of AFN (L&C AFN; e.g., transportation, civic participation, communication and information, communal participation, health services and resources, housing, ease of walkability, and building and outdoor spaces) to cognitive aging, functional decline, and emerging frailty; b) delineate variations by age and educational attainment and income in these linkages across the lifespan; and c) identify underlying mechanistic person-level biopsychosocial pathways of risk (e.g., cigarette use, cardiometabolic disease) and resilience (e.g., social capital, physical activity). The current project will be the first to thoroughly assess and integrate these goals. Linked to the ongoing Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) epidemiological cohort study, we propose an investigation of up to 800 midlife to older participants (ages 30-64 at baseline), tracked up to 13 years across three waves, born and residing in Baltimore, Maryland. This will allow detailed study of longitudinal life experiences to their residential neighborhoods through lifetime residential histories and contemporary activity spaces, obtained by calendar interview and LexisNexis commercial data and linked to rich administrative and archival data from the last 100 years. We will first model potential interactive and independent relations of L&C AFN to change in cognitive and physical function and frailty with further examination of effect modifiers (e.g., age). We will then build structural equation models to address the direct and indirect paths of influence exerted by L&C AFN on trajectories of change in these outcomes via AFN factors, person-level experiences, and related psychological, behavioral, and biomedical health factors. We will partner with Baltimore-based community partners to disseminate our findings to support local and ongoing health advocacy work that seeks transformative changes to improve healthy aging in place. Understanding and disseminating findings on the patterns and mechanistic processes linking L&C AFN to accelerated cognitive aging, functional decline, and frailty is critical to the development of suitable strategies to disrupt accelerated aging and instead promote healthy aging in place throughout our neighborhoods.
